Increase in the Prevalence of Carbapenem-Resistant Acinetobacter Isolates and Ampicillin-Resistant Non- Typhoidal Salmonella Species
2
조회
0
다운로드
20
인용
0
참고문헌
키워드
초록
Background: Antimicrobial surveillance is important for providing an up-to-date understanding of the epidemiology of antimicrobialresistance and for creating a forum for rational drug development. In this study, we analyzed antimicrobial test data generatedin 2011 by hospitals and commercial laboratories participating in the Korean Nationwide Surveillance of AntimicrobialResistance program (KONSAR). Materials and Methods: Data on the results of susceptibility tests conducted in 32 hospitals and two commercial laboratorieswere analyzed. Data on isolates from patients admitted to an intensive care unit (ICU) and those admitted to other wards werecompared. Intermediate susceptibility was not analyzed and duplicate isolates were excluded. Results: Escherichia coli was the most prevalent organism identified in both the hospital and commercial laboratories. Amongthe hospital isolates, methicillin-resistant Staphylococcus aureus (MRSA), penicillin G-non-susceptible Streptococcus pneumoniae,and ampicillin-resistant Enterococcus faecium remained as prevalent as they were in 2009. The proportion of vancomycin-resistant E. faecium (VR-EFM) slightly decreased from 29% in 2009 to 23% in 2011. Resistance rates of Klebsiellapneumoniae to ceftazidime, cefoxitin, fluoroquinolone, and amikacin were 24%, 14%, 27%, and 8%, respectively. Resistancerates of Pseudomonas aeruginosa to fl uoroquinolone, ceftazidime, imipenem, and amikacin were 33%, 20%, 22%, and16%, respectively, whereas those of Acinetobacter spp. resistance were 71%, 66%, 64, and 51%, respectively. The prevalenceof oxyimino-cephalosporin-resistant E. coli and K. pneumoniae, carbapenem-resistant Acinetobacter spp. and P. aeruginosa,MRSA, and VR-EFM among ICU isolates was higher than those among non-ICU isolates. Extended-spectrum β-lactamase-GproducingE. coli and K. pneumoniae, imipenem-resistant P. aeruginosa, and VR-EFM were more prevalent among isolates fromcommercial laboratories than those from hospitals. Resistance rates of K. pneumoniae to ceftazidime and amikacin decreased from32% and 24% in 2005 to 24% and 8% in 2011, respectively. The resistance rate of P. aeruginosa to amikacin decreased from 22%in 2005 to 16% in 2011. The proportion of imipenem-resistant Acinetobacter spp. increased from 16% in 2005 to 64% in 2011. Conclusions: The prevalence of MRSA, penicillin G-non-susceptible S. pneumoniae, and ampicillin-resistant E. faecium amongclinical isolates tested in laboratories remained high. Multidrug resistance was more prevalent among isolates from ICUs. Theprevalence of ceftazidime-resistant and amikacin-resistant K. pneumoniae and amikacin-resistant P. aeruginosa decreased after2005, while the prevalence of imipenem-resistant Acinetobacter spp. increased.
Abstract
Background: Antimicrobial surveillance is important for providing an up-to-date understanding of the epidemiology of antimicrobialresistance and for creating a forum for rational drug development. In this study, we analyzed antimicrobial test data generatedin 2011 by hospitals and commercial laboratories participating in the Korean Nationwide Surveillance of AntimicrobialResistance program (KONSAR). Materials and Methods: Data on the results of susceptibility tests conducted in 32 hospitals and two commercial laboratorieswere analyzed. Data on isolates from patients admitted to an intensive care unit (ICU) and those admitted to other wards werecompared. Intermediate susceptibility was not analyzed and duplicate isolates were excluded. Results: Escherichia coli was the most prevalent organism identified in both the hospital and commercial laboratories. Amongthe hospital isolates, methicillin-resistant Staphylococcus aureus (MRSA), penicillin G-non-susceptible Streptococcus pneumoniae,and ampicillin-resistant Enterococcus faecium remained as prevalent as they were in 2009. The proportion of vancomycin-resistant E. faecium (VR-EFM) slightly decreased from 29% in 2009 to 23% in 2011. Resistance rates of Klebsiellapneumoniae to ceftazidime, cefoxitin, fluoroquinolone, and amikacin were 24%, 14%, 27%, and 8%, respectively. Resistancerates of Pseudomonas aeruginosa to fl uoroquinolone, ceftazidime, imipenem, and amikacin were 33%, 20%, 22%, and16%, respectively, whereas those of Acinetobacter spp. resistance were 71%, 66%, 64, and 51%, respectively. The prevalenceof oxyimino-cephalosporin-resistant E. coli and K. pneumoniae, carbapenem-resistant Acinetobacter spp. and P. aeruginosa,MRSA, and VR-EFM among ICU isolates was higher than those among non-ICU isolates. Extended-spectrum β-lactamase-GproducingE. coli and K. pneumoniae, imipenem-resistant P. aeruginosa, and VR-EFM were more prevalent among isolates fromcommercial laboratories than those from hospitals. Resistance rates of K. pneumoniae to ceftazidime and amikacin decreased from32% and 24% in 2005 to 24% and 8% in 2011, respectively. The resistance rate of P. aeruginosa to amikacin decreased from 22%in 2005 to 16% in 2011. The proportion of imipenem-resistant Acinetobacter spp. increased from 16% in 2005 to 64% in 2011. Conclusions: The prevalence of MRSA, penicillin G-non-susceptible S. pneumoniae, and ampicillin-resistant E. faecium amongclinical isolates tested in laboratories remained high. Multidrug resistance was more prevalent among isolates from ICUs. Theprevalence of ceftazidime-resistant and amikacin-resistant K. pneumoniae and amikacin-resistant P. aeruginosa decreased after2005, while the prevalence of imipenem-resistant Acinetobacter spp. increased.
참고문헌 (22)
- Chong Y, "Korean nationwide surveillance of antimicrobial resistance of bacteria in 1997", Yonsei Med J, 39, pp.569~577 (1998)
- Performance standards for antimicrobial susceptibility testing, "Clinical and Laboratory Standards Institute", CLSI, ~, pp.nineteenth informational supplement M100-S19 (2009)
- Performance standards for antimicrobial susceptibility testing; twentyfirst informational supplement, "Clinical and Laboratory Standards Institute", CLSI, ~, pp.CLSI document M100-S21 (2011)
- O’Brien TF, "WHONET: removing obstacles to the full use of information about antimicrobial resistance", Diagn Microbiol Infect Dis, 25, pp.162~168 (1996)
- 이경원, "Increase of Ceftazidime- and Fluoroquinolone-Resistant Klebsiella pneumoniae and Imipenem-Resistant Acinetobacter spp. in Korea: Analysis of KONSAR Study Data from 2005 and 2007", Yonsei Medical Journal, 51(6), pp.901~911 (2010), 연세대학교의과대학
- Fridkin SK, "Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals", Emerg Infect Dis, 8, pp.697~701 (2002)
- Van Beneden CA, "Aggregated antibiograms and monitoring of drug-resistant Streptococcus pneumoniae", Emerg Infect Dis, 9, pp.1089~1095 (2003)
- Sahm DF, "Antimicrobial resistance in key bloodstream bacterial isolates: electronic surveillance with the Surveillance Network Database--USA", Clin Infect Dis, 29, pp.259~263 (1999)
- Felmingham D, "The Alexander Project 1996-1997: latest susceptibility data from this international study of bacterial pathogens from community-acquired lower respiratory tract infections", J Antimicrob Chemother, 45, pp.191~203 (2000)
- Clinical and Laboratory Standards Institute, "Analysis and presentation of cumulative antimicrobial susceptibility test data; approved guideline-Third Edition" (2008), CLSI
- Zhanel GG, "Antimicrobial-resistant pathogens in intensive care units in Canada: results of the Canadian National Intensive Care Unit (CAN-ICU) study, 2005-2006", Antimicrob Agents Chemother, 52, pp.1430~1437 (2008)
- Neuhauser MM, "Antibiotic resistance among gramnegative bacilli in US intensive care units: implications for fluoroquinolone use", JAMA, 289, pp.885~888 (2003)
- Rosenthal VD, "International Nosocomial Infection Control Consortium (INICC)report, data summary for 2003-2008, issued June 2009", Am J Infect Control, 38, pp.95~104 (2010)
- 이경원, "Further Increases in Carbapenem-, Amikacin-, and Fluoroquinolone-Resistant Isolates of Acinetobacter spp. and P. aeruginosa in Korea: KONSAR Study 2009", Yonsei Medical Journal, 52(5), pp.793~802 (2011), 연세대학교의과대학
- Bae S, "Antimicrobial resistance in Haemophilus influenzae respiratory tract isolates in Korea: results of a nationwide acute respiratory infections surveillance", Antimicrob Agents Chemother, 54, pp.65~71 (2010)
- Lee K, "Wide dissemination of OXA-type carbapenemases in clinical Acinetobacter spp. isolates from South Korea", International Journal Of Antimicrobial Agents, 33(6), pp.520~524 (2009)
- Ko KS, "High rates of resistance to colistin and polymyxin B in subgroups of Acinetobacter baumannii isolates from Korea", JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 60(5), pp.1163~1167 (2007), OXFORD UNIV PRESS
- 이경원, "Multidrug-Resistant Acinetobacter spp.: Increasingly Problematic Nosocomial Pathogens", Yonsei Medical Journal, 52(6), pp.879~891 (2011), 연세대학교의과대학
- Cai Y, "Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies", J Antimicrob Chemother, 67, pp.1607~1615 (2012)
- 성흥섭, "Imipenem 내성 Acinetobacter baumannii에서 항균제 병합요법의 시험관내 상승작용 검사", Annals of Laboratory Medicine, 27(2), pp.111~117 (2007), 대한진단검사의학회
- Poirel L, "OXA-48-like carbapenemases:the phantom menace", J Antimicrob Chemother, 67, pp.1597~1606 (2012)
- Potron A, "Genetic and biochemical characterisation of OXA-232, a carbapenem-hydrolysing class D β-lactamase from Enterobacteriaceae", Int J Antimicrob Agents, 41, pp.325~329 (2013)